Chronic opioid therapy and central sensitization in sickle cell disease

Christopher P Carroll, Sophie Lanzkron, Carlton Haywood, Kasey Kiley, Megan Pejsa, Gyasi Moscou-Jackson, Jennifer Haythornthwaite, Claudia Campbell

Research output: Contribution to journalArticle

Abstract

Chronic opioid therapy (COT) for chronic non-cancer pain is frequently debated, and its effectiveness is unproven in sickle cell disease (SCD). The authors conducted a descriptive study among 83 adult SCD patients and compared the severity of disease and pain symptoms among those who were prescribed COT (n=29) with those who were not using COT. All patients completed baseline laboratory pain assessment and questionnaires between January 2010 and June 2014. Thereafter, participants recorded daily pain, crises, function, and healthcare utilization for 90 days using electronic diaries. Analyses were conducted shortly after the final diary data collection period. Patients on COT did not differ on age, sex, or measures of disease severity. However, patients on COT exhibited greater levels of clinical pain (particularly non-crisis); central sensitization; and depression and increased diary measures of pain severity, function, and healthcare utilization on crisis and non-crisis diary days, as well as a greater proportion of days in crisis. Including depressive symptoms in multivariate models did not change the associations between COT and pain, interference, central sensitization, or utilization. Additionally, participants not on COT displayed the expected positive relationship between central sensitization and clinical pain, whereas those on COT demonstrated no such relationship, despite having both higher central sensitization and higher clinical pain. Overall, the results point out a high symptom burden in SCD patients on COT, including those on high-dose COT, and suggest that nociceptive processing in SCD patients on COT differs from those who are not.

Original languageEnglish (US)
Pages (from-to)S69-S77
JournalAmerican Journal of Preventive Medicine
Volume51
Issue number1
DOIs
StatePublished - Jul 1 2016

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Central Nervous System Sensitization
Sickle Cell Anemia
Opioid Analgesics
Therapeutics
Depression
Delivery of Health Care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Chronic opioid therapy and central sensitization in sickle cell disease. / Carroll, Christopher P; Lanzkron, Sophie; Haywood, Carlton; Kiley, Kasey; Pejsa, Megan; Moscou-Jackson, Gyasi; Haythornthwaite, Jennifer; Campbell, Claudia.

In: American Journal of Preventive Medicine, Vol. 51, No. 1, 01.07.2016, p. S69-S77.

Research output: Contribution to journalArticle

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